Individual provider Active NPI

Connie Lee Russell, RPH

  • Pharmacist
  • Nashville, TN
National Provider Identifier
1063797587
Registry record updated Oct 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
4462 Issued in TN
Practice address
2244 Murfreesboro Rd
Nashville, TN 37217-3313
Phone
(615) 367-0733
Fax
(615) 366-0964
NPI assigned
Oct 16, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 4462 TN Primary

Addresses

Primary practice location

2244 Murfreesboro Rd
Nashville, TN 37217-3313

Mailing address

2244 Murfreesboro Rd
Nashville, TN 37217-3313
Phone (615) 367-0733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
4462TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318723200000",
    "number": "1063797587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2244 MURFREESBORO RD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372173313",
            "telephone_number": "615-367-0733",
            "fax_number": "615-366-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2244 MURFREESBORO RD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372173313",
            "telephone_number": "615-367-0733",
            "fax_number": "615-366-0964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "CONNIE",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-16",
        "last_updated": "2011-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "4462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.